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Individual

DR. JANELLE P. GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
5709 MARKET ST STE I, OAKLAND, CA 94608-2811
(415) 902-2134
(909) 706-3942
Mailing address
134 HARKNESS AVE, SAN FRANCISCO, CA 94134-2122
(415) 902-2134
(510) 444-1966

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
213E00000X
Podiatrist
Primary
E5039
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
E5039
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E5039
CA
213ES0131X
Foot Surgery Podiatrist
E5039
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1581343
CA
01
CA144219
MEDICARE PTAN NO CAL
CA
01
CB229206
MEDICARE PTAN SO CAL
CA
01
E5039
CA DPM LICENSE
CA
Enumeration date
06/26/2009
Last updated
05/31/2023
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